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The Surgical outcomes of fundus-first technique in lowering the rate of bile duct injuries and bleeding during open cholecystectomy that facing intraoperative difficulties: A single-center prospective study: The surgical outcomes of open fundus-first cholecystectomy technique.
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Background: The problem of difficult gallbladder is not clearly defined and associated with real missing of therapeutic approaches that decreased morbidity. Moreover, the difficult gallbladder was reported as a contributing risk factor for biliary injury due to raised difficulty in surgical dissection within Calot’s triangle. The aim of this study is to determine the surgical outcomes of the open fundus-first cholecystectomy in lowering the rate of lethal intraoperative risks.

Subjects and Methods: Our prospective study conducted during the period of January 2019 to December 2022 at Ibn Sina specialized hospital, Khartoum, Sudan, for two hundred and fifty-three patients underwent elective open fundus-first cholecystectomy for intraoperative difficulties.

Results: the majority of cases had long-standing cholelithiasis with intraoperative difficulties revealed by pre-operative TUS and MRCP which required open fundus-first cholecystectomy in 173 (68.4%) of patients, (P-value <0.05). The operative surgical time was 120 minutes in 103 patients (40.7%), (P-value <0.05). During open cholecystectomy, variable intraoperative difficulties were found in all patients, (P-value <0.05) and were divided into: (A) Contracted intra-hepatic gallbladder seen in 157 (62.1%) of cases; (B) Distorted anatomy within Calot's triangle seen in 135 (53.4%) of patients; and (C) Intraoperative bleeding from the liver bed was observed as bloody oozing form in 150 (59.3%) of cases. Our patients had minimal postoperative complications like mild wound infection in 8 (3.2%) of cases and mortality rate was zero. 

Conclusions: There is a need for appropriate therapeutic and preventive strategies in healthcare systems for safe dealing with difficult cholecystectomy. Unclear anatomy due to severe inflammatory dense adhesions at Calot’s triangle and CBD stones needing difficult surgeries are the most important limiting factors for fundus-first laparoscopic cholecystectomy. Hence, we humbly recommend an open approach of fundus-first cholecystectomy as safe surgical option to reduce the incidence of bile duct injuries and intra-operative bleeding.

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Publication Date
Sun Dec 31 2023
Journal Name
Revue Académique De La Recherche Juridique
Humanizing Legal Rules (The Winter Truce in France as a Model)
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Since the law is the tool for implementing the state’s public policies, it is natural that its provisions (or at least some of them) seek to preserve human dignity as the source on which all rights and freedoms are based. One of the examples of humanizing the provisions of the law in France is what is known as the winter truce. What is this truce, what are the justifications for granting it, what is its historical origin, how did the legislative treatment of it develop, what are the similarities and differences between it and other legal periods included in French law, what is the scope of its application, and what are the effects resulting from it. These questions and others are what we will try to answer through this research.

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Publication Date
Wed May 01 2024
Journal Name
Journal Of Physics: Conference Series
A modified ARIMA model for forecasting chemical sales in the USA
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Abstract<p>model is derived, and the methodology is given in detail. The model is constructed depending on some measurement criteria, Akaike and Bayesian information criterion. For the new time series model, a new algorithm has been generated. The forecasting process, one and two steps ahead, is discussed in detail. Some exploratory data analysis is given in the beginning. The best model is selected based on some criteria; it is compared with some naïve models. The modified model is applied to a monthly chemical sales dataset (January 1992 to Dec 2019), where the dataset in this work has been downloaded from the United States of America census (www.census.gov). Ultimately, the forecasted sales </p> ... Show More
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Publication Date
Wed May 14 2025
Journal Name
Reproductive Biology And Endocrinology
The aryl hydrocarbon receptor: a new frontier in male reproductive system
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Background: The aryl hydrocarbon receptor (AhR) is a ligand-activated transcription factor historically recognized for its role in the regulation of toxicity mediated by environmental chemicals. Recent research points to AhR's critical participation in male reproductive physiology, particularly in spermatogenesis, hormone signaling, and the maintenance of sperm quality. Both endogenous ligands (e.g., dietary and gut microbiota-derived metabolites) and exogenous pollutants (e.g., dioxins and benzo-α-pyrene) influence AhR-mediated pathways, making it a key link between environmental exposures and male fertility. Results: This review highlights AhR's influence on the male reproductive system, emphasizing the role of endogenous AhR ligands an

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Publication Date
Tue Aug 15 2023
Journal Name
Journal Of Current Researches On Social Sciences
An Examination of Discourse Investigation of Fallacies in Religious Texts: Islam as a Case Study
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BN RASHİD, 2023

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Publication Date
Tue Dec 01 2020
Journal Name
Journal Of Engineering
A Case Study of Bus Line Passenger Volumes of Bakrajo Bus Lines in Sulaimani City
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Transit agencies constantly need information about system operations and passengers to support their regular scheduling and operation planning processes. The lack of these processes and cultural motivations to use public transportations contributes enormously to the reliance on the private cars rather than public transportation, resulting in traffic congestions. The traffic congestions occur mainly during peak hours and the accidents happening as a result of road accidents and construction works.  This study investigates the effects of weekday and weekend travel variability on peak hours of the passenger flow distribution on bus lines, which can effectively reflect the degree of traffic congestion. A study of passen

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Publication Date
Tue Sep 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
Conservation Nursing Strategies (*)An exploratory study of a sample of managers in Baghdad health departments
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The deficiency in the nurse staff  in the health organizations consider an important problem that must be studied and solved basically , not only because it affect on the health organization and it's strategic goals , but also it affect the human being and it's health which can't be substituted with anything or delayed in it's treatment ,This research aims to  necessary for health organizations to strategically help in maintaining the nurse staff and to keep that in it's strategic orientation and it's mission , moreover , the health organizations must study the reality of the nurse in the health organizations and know the causes beyond leaving the  nurse staff  the nurse job , and then remove

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Publication Date
Wed Oct 10 2018
Journal Name
Al-kindy College Medical Journal
Life style modification in the management of hypertension in a sample of hypertensive patients attending Primary Health Care centers at Baghdad city
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Background: Modifications of life style are often critically important to adequately control excising hypertension.

Objective: :to determine the source of information regarding hypertension and lifestyle modification practices in the management of hypertension in a sample of Iraqi hypertensive patients.

Type of the study: Across-sectional study.:

Methods:  The study was conducted over a period of two months during November and December 2015 at Primary Health Care center of Baghdad Al-GidedaAwaland Bab Al Mudhum primary health care centers. The sample included 219 hypertensive patients (102 females and 117males).  They were subjected to a

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Publication Date
Thu Mar 13 2025
Journal Name
Adab Al-rafidain
Guilt in The Condamned of ALtona of Sartre
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Drama "The Condamned of Altona" shows many different aspects of the 20th century. It contrasts strong, self-assured characters with weak, unsure ones to address absurdism and existentialism. Also, this piece shows the misery of the decade by showing Frantz, one of the play's heroes, taking his own life. Through suicide, disillusionment, and worry, the play depicts the upheaval of the 20th century, which was marred by numerous crises. The play's depiction of the jail and its inmates exemplifies the regret that accompanied the two world wars . Not only does guilt serve as a metaphor for the wrongs done by the Germans, but it also serves as a metaphor for the French inactivity during the occupation. And also the writers who did not devote thei

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Publication Date
Fri Jun 20 2025
Journal Name
Bulletin Of The Iraq Natural History Museum
INVESTIGATION OF MACROFUNGI IN THE MIDDLE OF IRAQ
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The study aimed to survey mushroom species from fields among herbs, palm trunks, and trees in central Iraq and to identify them on the basis of morphological and molecular characteristics. As a molecular identification result with polymerase chain reaction six species were recorded (with eight isolates): Agaricus bitorquis (Quéllt) Saccardo. 1887 (SHA14); Candolleomyces candolleanus (Fr.) D. Wächter & Melzer, 2020 (SHA15); Cyclocybe cylindracea (D.C.) Vizzini & Angelini, 2014 (SHA13); Leucoagaricus hesperius Vellinga, 2010 (SHA16); Volvariella sp. (SHA17), and Volvopluteus gloiocephalus (D. C.) Vizzini, Contu & Justo, 2011 (SHA10, SHA101 and SHA12), belonging to four families of Basidiomycetes: Agaricaceae, Pluteaceae,

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Publication Date
Wed Feb 20 2019
Journal Name
Iraqi Journal Of Physics
The influence of CdCl2 layer and annealing process on the structural and electrical properties of CdTe films
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A polycrystalline CdTefilms have been prepared by thermal evaporation technique on glass substrate at room temperature. The films thickness was about700±50 nm. Some of these films were annealed at 573 K for different duration times (60, 120 and 180 minutes), and other CdTe films followed by a layer of CdCl2 which has been deposited on them, and then the prepared CdTe films with CdCl2 layer have been annealed for the same conditions. The structures of CdTe films without and with CdCl2 layer have been investigated by X-ray diffraction. The as prepared and annealed films without and with CdCl2 layer were polycrystalline structure with preferred orientation at (111) plane. The better structural pr

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